• 제목/요약/키워드: Primary Health Clinic

검색결과 181건 처리시간 0.019초

연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査) (A Basie Health Survey of the Yonsei Community Health Service Area, Seoul)

  • 양재모;김명호
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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중·고등학생의 구강건강신념이 구강건강관리행동에 미치는 영향: 건강신념모형을 적용하여 (The impact of health belief model in the middle and high school students on oral health behaviors)

  • 임희정;김형주;안용순
    • 한국치위생학회지
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    • 제15권1호
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    • pp.111-118
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    • 2015
  • Objectives: The aim of the study is to investigate the health belief model affecting the oral health behavior in middle and high school students. Methods: The subjects were 296 middle and high school students in Seoul, Gyeonggi and Incheon from February 15 to March 21, 2014. The students filled out the self-reported questionnaires after receiving informed consents. The instrument was adopted and revised from those of Kim & Hwang, and Choi & Joo. The questionnaire consisted of 4 questions of general characteristics, 9 questions of oral health status including subjective oral health status, frequency of tooth brushing, duration of tooth brushing, method of tooth brushing, use of oral health devices, dental clinic visit, scaling services, snack intake, and smoking. The oral health belief consisted of 25 questions including susceptibility, seriousness, barriers, benefit, and self-efficacy using Likert 5 scale. The reliability of Cronbach's alpha in the study was 0.725. Data were analyzed using SPSS ver 18.0 for frequency analysis, t-test, ANOVA, ${\chi}^2$-test, and Pearson's correlation coefficient, simple regression, and binary logistic regression. Results: Oral health beliefs of middle and high school students affected the oral health behaviors. Susceptibility, barriers and self-efficacy also influenced on the oral health behaviors. In order to provide the best oral health education, susceptibility and self-efficacy are the primary factors to increase motivation because the motivation endows the students with correction of oral health behaviors that improve the knowledge, attitudes, and decrease barriers in oral hygiene. Conclusions: It is important to correct oral health behaviors in the middle and high school students by providing the continuing and systematic oral health education.

효율적 건강검진관리를 위한 미수검자의 특성 분석 - 건강보험 지역 가입자 중심으로 - (Analyses of the Non-Examinees' Characteristics for the Effective Health Screening Management)

  • 이애경;이선미;박일수
    • 보건행정학회지
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    • 제16권1호
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    • pp.54-72
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    • 2006
  • This study was conducted as the primary work to develop a customer relationship management (CRM) system to improve the performance of health screening programs. The specific aims of the study was to identify and classify the characteristics of the people who did not receive their health screening using decision trees and to propose management strategies according to their characteristics identified. The data on a total of 5,102,761 subjects of health screening provided by the National Health Insurance Program in the year of 2002 were used. The target variable was whether they underwent their health screening. The input variables included a total of 27. The SAS 9.1 version was used for data preprocessing and statistical analyses. SAS Enterprise Miner was used to develop the decision trees model. The decision trees identified the factors greatly affecting the health screening. In the non-disease group, the highest rate of non-examinees was characterized by: no experience of receiving a health screen, household's age, non-insured episode for the last one year, and patients' age. In the disease group, the one showing the highest rate of non-examinees was characterized by: no experience of receiving a health screening, no experience of going to public health center or midwife clinic for the last one year, and examinees' age. Developing CRM systems for health screening management taking into account the individual characteristics would be considerably helpful to increase the rate of receiving health screening.

소아청소년과 외래를 방문한 부모들의 발열공포와 관련 요인 (Fever Phobia: A Survey of Children's Parents in a Pediatric Outpatient Clinic)

  • 최애란;김진선
    • Child Health Nursing Research
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    • 제20권2호
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    • pp.113-122
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    • 2014
  • 목적 일 지역 소아청소년과 외래를 방문한 부모들의 자녀의 발열에 대한 발열공포의 수준 및 부모의 발열염려 정도와 대상자의 특성 간의 관련성을 파악하고자 함이다. 방법 소아청소년과 외래를 방문한 부모 151명을 대상으로 구조화된 자기기입식 설문지를 이용하여 자료를 수집하였다. 수집된 자료는 기술통계 및 카이제곱 검정을 통해 분석하였다. 결과 약 50%의 대상자들이 $37.8^{\circ}C$를 발열의 최저기준 체온으로 그리고 $38.9^{\circ}C$를 고열의 최저기준 체온으로 정의했다. 약 3/4의 대상자들이 발열의 해로운 효과로 경련과 뇌손상을 언급했으며, 발열에 대해 '매우 염려'를 하였고, 자녀의 발열 시 1시간 이내에 체온을 다시 측정하였고, 미온수 목욕을 제공했으며, 열성질환이 있는 경우 잠자는 아동을 해열제를 주기 위해 깨웠다. 부모의 자녀 발열에 대한 염려는 이전 열성 경련 경험 여부와 한 자녀 가정의 부모와 통계적으로 유의한 관련성이 있었다. 결론 소아청소년과 외래를 방문한 부모들에게도 발열공포가 광범위하게 존재하고 있었다. 부모들을 위한 발열 및 발열 관리 교육 프로그램의 개발과 평가가 요구된다. 의사와 간호사가 부모들의 발열관련 정보의 1차적 근원임을 고려할 때 건강관리제공자들은 부모들의 발열에 대한 비현실적인 공포를 경감시키는 데 중요한 역할을 하여야 할 것이다.

A Validation Study for the Korean Version of Chronic Obstructive Pulmonary Disease Assessment Test (CAT)

  • Hwang, Yong Il;Jung, Ki-Suck;Lim, Seong-Yong;Lee, Yil-Seob;Kwon, Nam-Hee
    • Tuberculosis and Respiratory Diseases
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    • 제74권6호
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    • pp.256-263
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    • 2013
  • Background: Health status measure is not only important for clinical research studies but also for clinical practices of chronic obstructive pulmonary disease (COPD) patients. The objective of this study is to evaluate the validity of the Korean Version of COPD Assessment Test (CAT) in primary care clinics as well as in referral hospitals. Methods: Smokers or ex-smokers, aged 40 years or older, with a smoking history of >10 pack-years; and a COPD diagnosis in the past 6 months or more, were recruited from 4 primary care clinics and 2 referral hospitals. Demographic, medical, and spirometry data was collected from patients who completed the CAT and St. George Respiratory Questionnaire (SGRQ), and had their dyspnea been assessed. The primary endpoint was the correlation between of the Korean version of CAT with SGRQ in patients with COPD. Results: A total 100 patients were enrolled. The mean age and smoking amounts were $69.2{\pm}8.4$ years and $40.6{\pm}22.3$ pack-years, respectively. Sixty-seven percent of the patients reported at least one exacerbation in the past year. The mean CAT score was $16.9{\pm}8.0$. The internal consistency assessed by Cronbach's alpha was 0.85. The CAT score was positively correlated with the SGRQ score (r=0.76, p<0.0001) and each component of SGRQ: symptoms, activity and impacts; r=0.68, r=0.61, and r=0.72, respectively (all p<0.0001). These positive correlations were preserved in the different groups (r=0.86, p<0.0001 in primary care clinic group; r=0.69, p<0.0001 in hospital group). The CAT score was also positively correlated to the Medical Research Council dyspnoea scale (r=0.46, p<0.0001). Conclusion: The Korean version of CAT had good internal consistency and showed good correlations with SGRQ. It can be used for assessing the impacts of COPD on the patient's health including primary care setting.

다발성 경부종격동 부갑상샘 선종증 1예 (A Case of Multiple Cervico-Mediastinal Parathyroid Adenomatosis)

  • 구범모;백문승;김승우
    • 대한두경부종양학회지
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    • 제36권1호
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    • pp.49-52
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    • 2020
  • The most common cause of primary hyperparathyroidism is a single adenoma accounts for more than 85% and about 1-2% in multiple occurrence. The adenoma arises mainly in the neck and rarely in the mediastinum. The simultaneous occurrence is extremely rare. A 73-year-old man came to our clinic complained about sense of falling forward during last eight months. The brain MRI and vestibular function test showed non-specific findings but total calcium and intact parathyroid hormone levels were markedly elevated. Radiologic studies and sesta-MIBI scan revealed multiple masses in lower paratracheal area and superior mediastinum. We performed mass excision with transcervical approach and all of them were diagnosed as parathyroid adenoma. After surgery, intact PTH and calcium levels returned to the normal range and his symptoms were dramatically improved. We report the unique and rare disease entity with a brief literature review.

동측의 이하선과 상경부에 공존하여 발생한 미만성 거대 B세포 및 여포성 림프종 1예 (A Case of Co-Existence of Diffuse Large B cell Lymphoma in Parotid Gland and Follicular Lymphoma in Upper Neck)

  • 홍석정;김은주;김승우
    • 대한두경부종양학회지
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    • 제34권1호
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    • pp.49-53
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    • 2018
  • Primary non-Hodgkin's lymphoma (NHL) rarely involves the parotid gland and its incidence is only 1.7% to 3.1% of all salivary gland neoplasms. The mucosa associated lymphoid tissue (MALT) is the most common subtype of NHL, followed by follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL). However, two distinct types of lymphomas occurring synchronously in the parotid gland and cervical lymph node have not been reported earlier. A 72-year-old man with rubbery-hard and fixed mass on the left parotid area came to our clinic. We performed the left total parotidectomy with ipsilateral excision of lymph node (level II), and he was finally diagnosed as DLBCL in parotid gland and FL in upper neck. It is presumed that the DLBCL appeared to be a transformation from FL. We report the unique and rare disease entity with brief literature review.

Clinico-pathological Features of Gynecological Malignancies in a Tertiary Care Hospital in Eastern India: Importance of Strengthening Primary Health Care in Prevention and Early Detection

  • Sarkar, Madhutandra;Konar, Hiralal;Raut, Deepak
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3541-3547
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    • 2013
  • Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

우리나라 당뇨병의 역학적 규모와 당뇨병 관리현황 파악을 위한 표본설계의 평가 (An Evaluation of Sampling Design for Estimating an Epidemiologic Volume of Diabetes and for Assessing Present Status of Its Control in Korea)

  • 이지성;김재용;백세현;박이병;이준영
    • Journal of Preventive Medicine and Public Health
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    • 제42권2호
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    • pp.135-142
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    • 2009
  • Objectives : An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. Methods : We analyzed about 250 million medical insurance claims data submitted to the Health Insurance Review & Assessment Service with diabetes as principal or subsequent diagnoses, more than or equal to once per year, in 2003. The database was re-constructed to a 'patient-hospital profile' that had 3,676,164 cases, and then to a 'patient profile' that consisted of 2,412,082 observations. The patient profile data was then used to test the validity of a proposed sampling frame and methods of sampling to develop diabetic-related epidemiologic indices. Results : Simulation study showed that a use of a stratified two-stage cluster sampling design with a total sample size of 4,000 will provide an estimate of 57.04%(95% prediction range, 49.83 - 64.24%) for a treatment prescription rate of diabetes. The proposed sampling design consists, at first, stratifying the area of the nation into "metropolitan/city/county" and the types of hospital into "tertiary/secondary/primary/clinic" with a proportion of 5:10:10:75. Hospitals were then randomly selected within the strata as a primary sampling unit, followed by a random selection of patients within the hospitals as a secondly sampling unit. The difference between the estimate and the parameter value was projected to be less than 0.3%. Conclusions : The sampling scheme proposed will be applied to a subsequent nationwide field survey not only for estimating the epidemiologic volume of diabetes but also for assessing the present status of nationwide diabetes control.

Predictors of Knowledge Level and Awareness towards Breast Cancer among Turkish Females

  • Aydogan, Umit;Doganer, Yusuf C.;Kilbas, Zafer;Rohrer, James E.;Sari, Oktay;Usterme, Necibe;Yuksel, Servet;Akbulut, Halil;Balkan, Salih M.;Saglam, Kenan;Tufan, Turgut
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권1호
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    • pp.275-282
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    • 2015
  • Background: Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. Objective: This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. Materials and Methods: The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. Results: Mean age of the participants was $46.2{\pm}9.93$ (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. Conclusions: It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.